In India, millions of people in rural and underserved communities have high blood pressure; many do not know, and don’t become symptomatic, until serious complications arise. Early detection and management are critical, not only to reduce the risk of stroke, heart attack and kidney failure, but also to improve health outcomes and ease the burden on health care systems.
To address this challenge, Project ECHO is equipping frontline health workers with the skills, confidence and tools they need to detect and manage hypertension in their communities.
Bridging the Gap
Project ECHO uses a telementoring model to bridge the gap between urban specialists and rural health care providers. In India, the community health providers include: Accredited Social Health Activists, Auxiliary Nurse Midwives, and community health volunteers.
An ECHO India telementoring session in progress, connecting health experts with frontline workers to strengthen hypertension care. Photo Credit: ECHO India
Through interactive training sessions, health workers learn to screen for high blood pressure, provide basic care, and refer to a doctor when needed, building local capacity to handle hypertension effectively.
Fighting Back: One Blood Pressure Check at a Time
“Before joining the ECHO sessions, I was hesitant about dealing with high blood pressure cases,” says Ayodhya Hande, an auxiliary nurse midwife in rural India. “Now I can confidently measure blood pressure, identify patients who need help, and advise them on medications and diet. I’ve seen more villagers stick to their treatment because they trust our guidance.”
“I learned simple ways to explain why controlling blood pressure is so important,” says Sushma Mule, an ASHA in a remote village. As part of her role, one day, Mule was screening in a community meeting and found one attendee’s levels were alarmingly high. “Thanks to my training, I got him to the clinic immediately and potentially helped prevent a stroke.”
Now, Mule goes door-to-door with a blood pressure monitor, making sure her neighbors get checked regularly.
By empowering local health workers, ECHO brings care closer to those who need it most. People—who would otherwise not receive medical care—are now diagnosed by a familiar face in their community. Hypertension may be a silent killer, but through shared learning and community trust, India’s health workers are fighting back – one blood pressure check at a time.
ECHO India conducts interactive hypertension training sessions for community health workers across India. Photo Credit: ECHO India
Results that Speak Volumes
Since 2021, ECHO India has provided free hypertension training across multiple states in partnership with government health departments. Thousands of community health workers have learned simple protocols for blood pressure checks, patient counseling and follow-up care.
According to a 2024 survey** of the ASHA training, communities with ECHO-trained workers have better detection of hypertension as well as better follow-up care. In a country facing a significant hypertension burden, Project ECHO is a beacon of hope. It shows that, with the right knowledge and support, frontline workers can expand access to care.
*ECHO India is nonprofit trust supporting ECHO partners across the country.
**ECHO India conducted the survey, results not published.
Explore how ECHO India is building capacity to combat hypertension in partnership with government health departments and community health workers.
Featured image: A visit with ECHO participants at the Urban Primary Health Centre located in Junnar, a city in the Pune district of Maharashtra. Health workers learn and apply skills gained through ECHO India’s hypertension training. Photo Credit: ECHO India